Intensive Care Service Model NSW Level 4 Adult Intensive Care Units

3.5 Telehealth solutions where appropriate to support clinical decisions making across networked hospitals.
Supporting information and evidence
• Telehealth is an example of a technological model that accelerates clinical problem solving and decision-making,
resulting in faster critical care delivery and improvement in patient outcomes
• Consider the use of telehealth solutions to facilitate the inclusion of offsite multidisciplinary team members in the
daily ward round and weekly multidisciplinary rounds within the ICU
• References: 22
• Aligns with in safe hands function 4 and 10 11
4. Patient safety & experience, quality outcomes & data
4.1 Regular local multidisciplinary Morbidity and Mortality (M&M) meetings and combined Intensive Care Network
multidisciplinary meetings: consider quarterly.
Supporting information and evidence
• Local M&M meetings are recommended to occur at least monthly. Smaller departments however may consider
meetings quarterly
• M&M meetings ideally include all deaths in ICU as well as adverse events
• Consider the use of telehealth solutions to support M&M meetings across the Intensive Care Service Network
• A process for review to include the following elements:
| | case identification
| | case preparation and review
| | case analysis
| | case discussion
| | case classification (severity, preventability)
| | case closure and follow up (recommendations and actions should be minuted).
14, 20, 32, 33
• References:
• Aligns with in safe hands function 5 11
4.2 Results of audit and incident reporting fed back to the multidisciplinary team, at minuted meetings minimum
monthly.
Supporting information and evidence
• Results should be further disseminated via all appropriate communication channels
• Audit and feedback can be effective in improving professional practice
• Timely feedback on incidents when delivered via effective communication channels promotes a safety culture
• Effective feedback involves timely corrective actions that improve systems, as well as dissemination to frontline
staff
• All staff need to participate in the review of performance procedures either individually, or as part of a team
25, 34, 35
• References:
• Aligns with in safe hands function 5 11
4.3 Antimicrobial stewardship in line with the CEC Quality Use of Antimicrobials in Healthcare.
Supporting information and evidence
• Various models to assist small to medium sized hospitals in antimicrobial stewardship have been proposed such as,
integration of restriction policies with a larger facility and approval via expert external advice
25, 36
• References:
• Aligns with in safe hands function 5 11
Intensive Care Service Network – Intensive Care Service Model: NSW Level 4 Adult Intensive Care Units Page 29